CN1175785C - Laser ablation system to eliminate cancerous embolism inside blood vessel or bile duct - Google Patents
Laser ablation system to eliminate cancerous embolism inside blood vessel or bile duct Download PDFInfo
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- CN1175785C CN1175785C CNB021374228A CN02137422A CN1175785C CN 1175785 C CN1175785 C CN 1175785C CN B021374228 A CNB021374228 A CN B021374228A CN 02137422 A CN02137422 A CN 02137422A CN 1175785 C CN1175785 C CN 1175785C
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- laser
- puncture needle
- cancer embolus
- blood vessel
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Abstract
The present invention provides a laser ablation system for eliminating cancer embolus in vessel cavities of blood vessels, bile vessels, etc., which relates to the technical field of a medical instrument. The present invention comprises a laser device (1), laser fiber (2) and a set of compliance puncture needles, wherein the laser device (1) is connected with the laser fiber (2), and the laser device and the laser fiber are the common semiconductor laser device and the common laser fiber in clinic; each compliance puncture needle comprises a puncture needle pipe (3), a puncture needle core (4), a guiding wire (5), a fiber conduit (6) and a guiding needle (7), and the guiding needle is composed of a needle handle (7.1), a linear part (7.2) of a needle part, and an arch part (7.3). Different specifications of compliance puncture needles can be selected according to different sizes and strikes of the vessel cavities of the cancer embolus, and the laser fiber is introduced into the cancer embolus which is ablated by lasers. The present invention provides a set of safe and effective treatment systems for eliminating the cancer embolus in the vessel cavities. A patient is free from the pain of operations by the present invention, and the present invention brings a wish for a patient who loses operation opportunities.
Description
Technical field:
The present invention relates to technical field of medical instruments, especially a kind of laser ablation system of eliminating cancer embolus in interior cancer embolus of blood vessel and the bile duct.
Background technology:
The blood vessel cancer embolus is the common disease that each stage all can occur in the tumor development process.For example, portal vein tumor thrombus is a kind of common disease in the hepatocarcinoma evolution, is one of immediate cause of liver cancer patient death, therefore, finds and remove the blood vessel cancer embolus as early as possible, just seems particularly important.
To blood vessel cancer embolus such as this disease of portal vein tumor thrombus, method commonly used clinically at present has:
1. adopt dehydrated alcohol or chemotherapeutics, iodate wet goods injection treatment.Because various medicines can't fine stop in blood vessel, so do not receive good curative effect.
When 2. being expert at the liver tumor resection operation, incision has the portal vein of cancer embolus to prop up, with suction pump the cancer embolus sucking-off, it is feasible that this method is used in art, but such patient's postoperative often can form portal vein tumor thrombus again once more very soon, at this moment usually apart from last time operating time shorter, the patient can't bear the operation of opening abdomen once more.And in a single day clinical most of patient find hepatocarcinoma, often all lost the surgical engine meeting, and therefore can directly opening abdomen, to draw the patient of cancer embolus very few, to most of patient and inapplicable.
3. the someone proposes to adopt high-energy ultrasonic focusing to melt portal vein tumor thrombus.The head that its ultrasound wave with certain frequency and power that utilizes supersonic generator to produce passes through the horn seal wire produces violent oscillation effect, cancer embolus is melted, simultaneously with the side opening of suction device by improved puncture needle the cancer embolus chip sucking-off of supersonic melting, be the cancerous cell recurrence that prevents to carry over, also need to pour into chemicals with further kill cancer cell, yet owing to various medicines all can't stop in blood vessel for a long time, so still might not reach the requirement of killing the affected part cancerous cell fully.
In a single day similar with it, the bile duct cancer embolus is more common in cancer of biliary duct and the hepatocarcinoma bile duct shifts, and forms cancer embolus in the bile duct, symptoms such as jaundice can appear in patient very soon, and in the past methods that adopt endoscopic retrograde cholangiopancreatography (ERCP) (ERCP) to place T-type drainage tube are down treated more.But along with the growth of cancer embolus, most patients can be very difficult at ERCP underlying pipe, often can not be successful, and blocked once more even the drainage tube of putting well also is very easy to.The bile duct cancer embolus also is a current clinical difficult problem that presses for solution.
At present, laser has been applied to tumor treatment, as the tumor of primary tumor, metastatic tumo(u)r and postoperative recurrence, especially is applicable to tolerate the tumor patient of operation once more.For tumors such as hepatocarcinoma, breast carcinoma, adrenal gland's adenocarcinoma, osteoid osteoma, pituitary tumor and prostate tumors, when using laser therapy, at ultrasonograph, radioscopy instrument (X line), computer-controlled x-ray tomography scanning (ComputedTomography, CT) or nuclear magnetic resonance, NMR (Magnetic Resonance Imaging, MRI) etc. under the image system orientation direction, common puncture needle percutaneous puncture is arrived in the tumor body, laser fiber can carry out laser therapy by common puncture needle tubing straight cutting therapentic part.Because laser therapy has the good demarcation line of killing and wounding, can pass through the complete kill tumor cell of regulation and control, and make the cell outside the ablation areas avoid damage.Yet, the common puncture needle that uses clinically is rectilinear at present, and blood vessel is not linear as the trend of portal vein in the liver or bile duct, and normally physiological multi-angle, anfractuose is not so see the report of using cancer embolus aspect in laser therapy blood vessel or the bile duct so far.
Summary of the invention:
The present invention has designed the compliance puncture needle of a cover adaptation blood vessel and the differently curved degree of bile duct, makes laser fiber arrive the corresponding site of blood vessel or bile duct cancer embolus under its guiding, thereby makes laser ablation blood vessel or bile duct cancer embolus be able to possibility.
Laser ablation system of the present invention comprises laser aid, laser fiber and a cover compliance puncture needle, and laser fiber is connected in laser aid.
The compliance puncture needle comprises puncture needle tubing, puncture needle nook closing member, seal wire, fibre-optic catheter and guide pin, and they are made by materials such as medical metal material and medical nylon respectively, as medical stainless steel material etc.Puncture needle tubing and puncture needle nook closing member are linear puncture needle tubing and puncture needle nook closing member commonly used clinically; Seal wire also is a common seal wire commonly used clinically, and thickness and nook closing member are suitable, so that insert needle tubing; The fibre-optic catheter thickness is identical with puncture needle tubing, can be placed in outside the seal wire; Guide pin is made of the linear part and the arch section of needle handle and pin portion, be equivalent to the extension that above-mentioned linear puncture needle nook closing member adds front end, the extension is different flexibility and length as required, it is the hard and soft appropriateness of material therefor, it can be stretched in conduit move ahead, can after stretching out conduit, be corresponding flexibility again; For controlling its crooked direction, needle handle is provided with corresponding sign.
During clinical use, the acupuncture of will puncturing is earlier extracted the puncture needle nook closing member out to the suitable position at cancer embolus place, inserts seal wire to the puncture needle tubing top along puncture needle tubing; Extract puncture needle tubing, put fibre-optic catheter up to guidewire tip; Extract seal wire out, along the guide pin of fibre-optic catheter insertion respective curved degree, guide pin is advanced to corresponding site with fibre-optic catheter along guide pin after thrusting the certain position of cancer embolus along blood vessel; If the place ahead blood vessel or bile duct trend change, then guide pin to be extracted out, the guide pin of flexibility is answered in commutation, successively fibre-optic catheter is pushed ahead gradually, is inserted into the end of cancer embolus always; At this moment, extract guide pin again out, insert laser fiber, again fibre-optic catheter is withdrawed from cancer embolus to the cancer embolus end.Laser is adjusted to certain intensity, make laser fiber in cancer embolus from front to back, retreat while melting, melted up to whole section cancer embolus, extract laser fiber and fibre-optic catheter external together at last.
Theoretically, laser ablation pipeline cancer embolus has feasibility.At first, the heat tolerance of normal tissue cell will be higher than cancerous cell, and the big I of laser hazard boundary is regulated and is controlled by the size and the length of action time of release laser power, thereby has a good demarcation line of killing and wounding, zoopery has proved that laser ablation has regional demarcation line, can make the outer cell of ablation areas avoid damage.Secondly, cancerous cell can be killed fully when the most characteristic characteristics of cancer embolus laser ablation just were that temperature is increased to 42～45 ℃, local cicatrixization, and absorbed gradually by body in the future.Therefore, utilize laser ablation system both can kill whole cancerous cell in the cancer embolus, can make normal blood vessels, the liver organization of periphery injury-free again.
From practical operation, the trend of portal vein or bile duct generally is not rectilinear in the liver, and normally physiological multi-angle, anfractuose uses puncture needle of the present invention just can comply with the trend of pipeline, and optical fiber is inserted cancer embolus, and this is a key of the present invention.Adopt the present invention to eliminate cancer embolus and belong to Minimally Invasive Surgery, safe, be beneficial to patients ' recovery, the expense of curing the disease is relatively low, so be easy to be accepted by hospitalized patients.
The present invention has been for the elimination of cancer embolus in the tube chambers such as blood vessel or bile duct provides one to overlap therapy system safely and effectively, both made patient avoid the hardship of abdominal, also make can't abdominal the chance that obtains medical treatment of patient.Because laser ablation has regional demarcation line, therefore, do not injure the purpose of normal surrounding tissue again as long as regulation and control suitably just can reach the cancerous cell that both thoroughly melts cancer embolus.
Description of drawings:
Fig. 1 is laser aid of the present invention and laser fiber sketch map
Fig. 2 is the structural representation of compliance puncture needle of the present invention
The specific embodiment:
Compliance puncture needle of the present invention comprises puncture needle tubing 3, puncture needle nook closing member 4, seal wire 5, fibre-optic catheter 6 and guide pin 7.200～300 millimeters of 3 length of puncture needle tubing (mm), internal diameter 200～400 μ m, external diameter 300～500 μ m, the length of the length of puncture needle nook closing member 4 and diameter and puncture needle tubing 3 and internal diameter coupling; The internal diameter coupling of seal wire 5 diameters and puncture needle tubing 3, length 400～1000mm; Fibre-optic catheter 6 external diameters and internal diameter be with puncture needle tubing 3, length 300～500mm; Guide pin 7 is made of linear part 7.2, the arch section 7.3 of needle handle 7.1 and pin portion, the internal diameter of the diameter of pin portion and fibre-optic catheter 6 coupling, the length of linear part 7.2 be with optical fiber conduit 6, arch section 7.3 length 10～100mm, radius of curvature 10～200mm, the top is a needle point.
For easy to operate and ensure safety, the needle handle 7.1 of guide pin 7 is provided with sign, and with the bending direction of identification arch section 7.3, this identifies available band colo(u)r streak bar, groove or projection expression, also available other labellings.Also can indicate the diameter of guide pin 7 pin portions, the radius of curvature of arch section 7.3 on the needle handle 7.1, so that select for use.
Below by embodiment, the invention will be further described.
Embodiment 1: the laser ablation system of portal vein tumor thrombus for example
Embodiment 2: the laser ablation system of bile duct cancer embolus for example
The compliance puncture needle of laser ablation system of the present invention, can select different specifications for use as required, for example: puncture needle tubing 3 length 300mm, internal diameter 400 μ m, external diameter 500 μ m, the length of the length of puncture needle nook closing member 4 and diameter and puncture needle tubing 3 and internal diameter coupling; The internal diameter coupling of seal wire 5 diameters and puncture needle tubing 3, length 1000mm; Fibre-optic catheter 6 external diameters and internal diameter are with puncture needle tubing 3, length 500mm.Join four guide pins 7, the internal diameter coupling of its diameter and fibre-optic catheter; The needle handle 7.1 of guide pin 7 is the hexahedron prismatic, establishes the bending direction sign of axial projection as arch section; The length of the linear part 7.2 of guide pin 7 is with optical fiber conduit 6, and the length of arch section 7.3 is 10,50,80 respectively, 100mm, and corresponding radius of curvature is 20,80,140 respectively, 200mm.
The present invention has obtained good result through clinic trial: postoperative 1,3,7 days is reined in the Ultrasound Instrument inspection with colour is multispectral, finds that the portal vein that the portal vein tumor thrombus patient is melted all has obvious blood flow signal, and day by day increases; Postoperative 1,3,7 days checks bile duct cancer embolus patient with the multispectral Ultrasound Instrument of reining in of colour, and checks liver function, and finding to melt cholangiectasis situation after 1 day just has obviously and alleviate, and 7 days basic recovers normal caliber, and chemical examination liver function bilirubin obviously descends.Usually portal vein tumor thrombus patient and biliary tract cancer embolus patient postoperative can be left hospital about 10 days.Safety of the present invention and effectiveness more than have been described.
Claims (7)
1. laser ablation system of eliminating cancer embolus in blood vessel or the bile duct, comprise laser aid (1), laser fiber (2), puncture needle tubing (3), puncture needle nook closing member (4), seal wire (5) and fibre-optic catheter (6), it is characterized in that also comprising guide pin (7), guide pin (7) is made of the linear part (7.2) and the arch section (7.3) of needle handle (7.1), pin portion, and laser aid (1) links to each other with laser fiber (2); Puncture needle tubing (3) is placed in outside the puncture needle nook closing member (4), so that thrust the suitable position at cancer embolus place; Extract puncture needle nook closing member (4) out, just seal wire (5) can be inserted into the needle tubing top along puncture needle tubing (3); Extract puncture needle tubing (3), fibre-optic catheter (6) is enclosed within outside the seal wire (5) and along seal wire (5) is inserted into guidewire tip; Extract seal wire (5) out, insert guide pin (7) along fibre-optic catheter (6), after guide pin thrusts the certain position of cancer embolus along blood vessel, fibre-optic catheter (6) along the guide pin reach, is pushed ahead the end of blood vessel or bile duct cancer embolus at the following fibre-optic catheter of the guiding of differently curved degree guide pin (6); Extract guide pin (7) this moment out, insert laser fiber (2) to the cancer embolus end, step back fibre-optic catheter again, regulate the laser intensity of laser fiber (2) with laser aid along fibre-optic catheter.
2. the laser ablation system of cancer embolus is characterized in that 200～300 millimeters of puncture needle tubing (3) length, 200～400 microns of internal diameters, 300～500 microns of external diameters in elimination blood vessel according to claim 1 or the bile duct; The length of the length of puncture needle nook closing member (4) and diameter and puncture needle tubing (3) and internal diameter coupling; The internal diameter coupling of seal wire (5) diameter and puncture needle tubing (3), 400～1000 millimeters of length; Fibre-optic catheter (6) external diameter and the same puncture needle tubing of internal diameter (3), 300～500 millimeters of length; The diameter of guide pin (7) pin portion and the internal diameter of fibre-optic catheter (6) coupling, the length of linear part (7.2) be with optical fiber conduit (6), 10～100 millimeters of arch section (7.3) length, and 10～200 millimeters of radius of curvature, the top is a needle point.
3. the laser ablation system of cancer embolus is characterized in that the needle handle (7.1) of guide pin (7) is provided with the sign of arch section (7.3) bending direction in elimination blood vessel according to claim 1 and 2 or the bile duct.
4. the laser ablation system of cancer embolus is characterized in that the needle handle (7.1) of guide pin (7) is marked with the numerical value of pin portion diameter and arch section (7.3) radius of curvature in elimination blood vessel according to claim 1 and 2 or the bile duct.
5. the laser ablation system of cancer embolus is characterized in that laser aid (1) is a semicondcutor laser unit in elimination blood vessel according to claim 1 and 2 or the bile duct.
6. the laser ablation system of cancer embolus is characterized in that laser aid (1) is a semicondcutor laser unit in elimination blood vessel according to claim 3 or the bile duct.
7. the laser ablation system of cancer embolus is characterized in that laser aid (1) is a semicondcutor laser unit in elimination blood vessel according to claim 4 or the bile duct.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CNB021374228A CN1175785C (en) | 2002-10-15 | 2002-10-15 | Laser ablation system to eliminate cancerous embolism inside blood vessel or bile duct |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CNB021374228A CN1175785C (en) | 2002-10-15 | 2002-10-15 | Laser ablation system to eliminate cancerous embolism inside blood vessel or bile duct |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN1403062A CN1403062A (en) | 2003-03-19 |
| CN1175785C true CN1175785C (en) | 2004-11-17 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CNB021374228A Expired - Fee Related CN1175785C (en) | 2002-10-15 | 2002-10-15 | Laser ablation system to eliminate cancerous embolism inside blood vessel or bile duct |
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| CN (1) | CN1175785C (en) |
Families Citing this family (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN101920072A (en) * | 2010-09-08 | 2010-12-22 | 中南大学 | Intracavitary visible photodynamic therapeutic instrument |
| EP4331519A2 (en) * | 2013-03-15 | 2024-03-06 | Medtronic Holding Company Sàrl | A system for treating tissue |
| US20180064415A1 (en) * | 2016-09-07 | 2018-03-08 | Siemens Medical Solutions Usa, Inc. | Acoustic ablation assisted intra-cardiac echocardiography catheter |
| CN108144176B (en) * | 2018-02-09 | 2024-04-05 | 南华大学附属第二医院 | Shunt device for bedside door body |
| CN108784802A (en) * | 2018-07-17 | 2018-11-13 | 中山大学附属第医院 | A kind of belt carcass puncture needle component |
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2002
- 2002-10-15 CN CNB021374228A patent/CN1175785C/en not_active Expired - Fee Related
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| Publication number | Publication date |
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| CN1403062A (en) | 2003-03-19 |
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